According to the Population and Housing Census (PHC) 2011, Bangladesh is one of the most densely populated countries in the world with a total population of 149.8 million. The population density is about 1015 persons per square kilometre (BBS 2012). Ensuring health services for the population is difficult but the government is striving to extend its reach to everyone. Bangladesh is currently spending 3.7 (4.0) percent of its GDP on the health sector. The total health expenditure as percentage of GDP remained at 4 percent (3.7 percent) in 2012. The General Government Expenditure on Health (GGHE) as percentage of Total Health Expenditure (THE) declined over the years to 34 percent (compared to 36 percent in 1995). Proportionately, the private expenditure on health increased to 66 percent in 2012. The out of pocket expenditure as percentage of Total Health Expenditure (THE) also increased over the years to 63 percent, which means that a significant share of the health expenditure is being borne by the people and care seekers.
When women are the care-seekers, they face some additional barriers compared to men. These barriers include those generated by unequal gender power relations and women’s subordinate status in the family and society, such as lack of allocation of funds for the female members of the household who may not be earning and whose health is not the top priority in the household. Only 12.9 percent of women take their own decisions regarding their health (BDHS 2011). Women also face barriers to accessing health care related to sexual and reproductive issues. Adolescents are a specific group who face problems in accessing SRH associated care and information. Often they are faced with legal barriers such as parental consent or age limits to access information and services. In addition to this, their access and rights to services are more often than not hindered by people’s perceptions and attitudes towards them as service users, where judgemental attitudes prevent adolescents from seeking services on SRH.
